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The Ontario government will return to arbitration with the province’s physicians – a twist that comes days after the province announced its intention to pull out of proceedings.

The reversal became official late on Friday morning, according to a letter Ontario Medical Association president Nadia Alam wrote to members announcing re-scheduled arbitration hearing dates on Dec. 18 and 21. The association was “formally advised” of the change, she wrote, although her letter was unclear about how. “Our mutual goal is to achieve a fair and reasonable outcome for doctors, patients and government," she said of the talks to reach a new contract with the province.

Ontario earlier this week announced its intent to cancel arbitration hearings, which the OMA denounced as an “affront to the rule of law.” The province said it acted because of acrimony within the profession. Last month, a group of high-billing specialists voted in an online referendum to leave the OMA, the official negotiator for nearly 31,000 physicians.

The Ontario Specialists Association says it has the support of eight specialty-physicians' groups and a mandate to urge the amendment of legislation that bars the province from negotiating doctors' fees with any group but the OMA. The OMA says fewer than 5 per cent of doctors voted to join the breakaway association.

“There is clearly a public dispute in the profession about whether the OMA is the exclusive representative of physicians in Ontario,” Craig Rix, a lawyer for the Ministry of Health and Long-Term Care (MOHLTC) wrote to the head of the arbitration board on Monday. “The MOHLTC lacks confidence that the OMA can deliver on the outcome of any arbitration decision.” The OMA told arbitrator William Kaplan that the suggestion it could not put a settlement into action was “unfounded and totally erroneous.” Either way, OMA lawyers argued Ontario could not unilaterally terminate arbitration.

“We believe the government is trying to pull the plug on arbitration because it knows arbitration will mean a fair deal for doctors,” Dr. Alam wrote to members on Tuesday evening. After arbitration was cancelled, the OMA said “all options” were on the table, including job action. As part of the binding arbitration framework reached in 2017 with the provincial Liberals, the medical association promised it would “not threaten, condone or encourage strike action by physicians.”

Hayley Chazan, a spokesperson for Health Minister Christine Elliott, on Friday criticized the OMA. “The Ontario government is disappointed in the Ontario Medical Association’s (OMA) rejection of our position that recent developments require that they consult with their membership in an effort to resolve the question of appropriate representation of physicians," she wrote in an e-mail.

Ms. Chazan said that consultation will still occur over representation, and the minister hoped the OMA would participate. On Wednesday, the government had dismissed its appointee – Kevin Smith, president of the University Health Network in downtown Toronto – from the three-member arbitration board. She noted on Friday that the province’s “nominee” would continue in his role.

Dr. Alam said hundreds of members had planned to attend the hearing originally scheduled for Saturday, and urged members to attend on Tuesday. “It is the OMA’s sincere hope this is the start of a more effective working relationship between the OMA and the government of Ontario," she wrote. "As the representative of Ontario’s physicians, the OMA – your OMA, we will take a strong and unified leadership role to transform the system including addressing hallway medicine and wait times.”

Physicians have been without a contract since March, 2014. Acrimony erupted when the previous Liberal government decided to claw back some fees and freeze others. Last year, Kathleen Wynne’s government agreed to allow binding arbitration.

The hearings began last spring. When Doug Ford’s government came to power in June, it converted some of the planned arbitration dates into negotiation days. The talks stalled, though, and arbitration resumed last month.

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